Sažetak
Akutni apendicitis je jedno od najčešćih abdominalnih stanja koji zahtevaju hiruršku intervenciju. Više od jednog veka otvorena apendektomija je bila zlatni standard kao bezbedna i efikasna procedura za tretman akutnog apendicitisa. U mnogim studijama laparoskopska apendektomija je dokazana kao bezbedna i superiorna metoda . Cilj našeg rada je poređenje rezultata laparoskopske i otvorene apendektomije u smisku trajanja operacije, intrahospitalnog boravka, postoperativnih komplikacija i postoperativnog bola.
Svi bolesnici koji su imali otvorenu ili laparoskopsku apendektomiju u periodu od godinu dana u Centru za minimalno invanzivnu hirurgiju i u Urgentnom centru Univerzitetskog Kliničkog centra u Nišu. Ukupan broj od 126 bolesnika je uključen u retrospektivnu studiju.
Istraživanje je uključilo 126 bolesnika kod kojih je izvršena apendektomija. Laporaskopska apendektomija je urađena kod 58 bolesnika, a otvorena apendektomija kod 68 bolesnika. Prema polnoj distribuciji ispitivane grupe su bile homogene (p = 0,780). Bolesnici od kojih je urađena laporaskopija su nešto mlađi u poređenju sa bolesnicima sa otvorenom apendektomijem, ali bez statističke značajnosti (p = 0,057). Prosečna visina (p = 0,123), težina (p = 0,200) i BMI (p = 0,425) su ujednačeni u obe ispitivane grupe.
Prethodne hirurške operacije su zastupljenije kod OA, ali bez statističke značajnosti (p = 0,141). Procenat bolesnika sa vrednostima WBC > 10 je isti u obe ispitivane grupe (p = 0,927).
Dijabetes mellitus je češći kod pacijenata sa OA, ali bez značajne razlike (p = 0,563).
Akutni i perforirani apendicitisi su podjenako zastupljeni u obe ispitivane grupe (p = 0,490).
Trajanje operacije se nije značajno razlikovalo između ispitivanih grupa (p = 0.751). Hospitalizacija je značajno kraća kod bolesnika kod kojih je urađena laporaskopska apendektomija (p < 0.001).
Tretman akutnog apendicitisa laparoskopskom hirurgijom u poređenju sa otvorenim pristupom daje bolje rezultate u smislu intrahospitalnog boravka, vremena oporavka, postoperativnih komplikacija i postoperativnog bola.
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Agresta F, De Simone P, Leone L, Arezzo A, Biondi A, Bottero L et al. Italian Society of Young Surgeons (SPIGC). Laparoscopic appendectomy in Italy: an appraisal of 26,863 cases. J Laparoendosc Adv Surg Tech A. 2004;14:1-8. [CrossRef] [PubMed]
Bennett J, Boddy A, Rhodes M. Choice of approach for appendicectomy: a meta-analysis of open versus laparoscopic appendicectomy. Surg Laparosc Endosc Percutan Tech. 2007;17(4):245-55. [CrossRef] [PubMed]
Bennett J, Boddy A, Rhodes M: Choice of approach for appendicectomy: a meta-analysis of open versus laparoscopic appendicectomy. Surg Laparosc Endosc Percutan Tech 2007,17:245-55. [CrossRef] [PubMed]
Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet 2015;386:1278-87. [CrossRef] [PubMed]
Biondi A, Grosso G, Mistretta A, Marventano S, Toscano C, Drago F, Gangi S, Basile F. Laparoscopic vs. open approach for colorectal cancer: evolution over time of minimal invasive surgery. BMC Surg. 2013;13(Suppl 2):S12. [CrossRef] [PubMed]
Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg 1999;177: 250-6. [CrossRef] [PubMed]
Di Saverio S, Birindelli A, Kelly MD, Catena F, Weber DG, Sartelli M et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg. 2016;11:34. [CrossRef] [PubMed]
Di Saverio S, Mandrioli M, Sibilio A, Smerieri N, Lombardi R, Catena F et al. A cost-effective technique for laparoscopic appendectomy: outcomes and costs of a case–control prospective single-operator study of 112 unselected consecutive cases of complicated acute appendicitis. J Am Coll Surg.2014;218:e51-e65. [CrossRef] [PubMed]
D'Souza N, Nugent K. Appendicitis. BMJ Clin Evid. 2014;2014:0408. [PubMed]
Fogli L, Brulatti M, Boschi S, Di Domenico M, Papa V, Patrizi P, Capizzi FD. Laparoscopic appendectomy for acute and recurrent appendicitis: retrospective analy-sis of a single-group 5-year experience. J Laparo-endosc Adv Surg Tech A 2002;12:107-10. [CrossRef] [PubMed]
Garbutt JM, Soper NJ, Shannon W, Botero A, Littenberg B. Meta-analysis of randomized controlled trials comparing laparoscopic and open appendec-tomy. Surg Laparosc Endosc. 1999;9:17-26. [CrossRef] [PubMed]
Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg. 2004;239: 43-52. [CrossRef] [PubMed]
Ignacio RC, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha PA. Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc. 2004;18:334-7. [CrossRef] [PubMed]
Ingraham AP, Cohen ME, Bilimoria KY, Pritts TA, Esposito TJ. Comparison of outcomes after laparo-scopic versus open appendectomy for acute appendi-citis at 222 ACS NSQIP hospitals. Surgery. 2010; 148(4):625-35. [CrossRef] [PubMed]
Jaschinski T, Mosch C, Eikermann M, Neugebauer EA. Laparoscopic versus open appendectomy in patients with suspected appendicitis: a systematic review of meta-analyses of randomized controlled trials. BMC Gastroenterol. 2015;15:48. [CrossRef] [PubMed]
Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg. 2005;242(3):439-48;discussion 48-50. [CrossRef] [PubMed]
Kehagias I, Karamanakos SN, Panagiotopoulos S, Panagopoulos K, Kalfarentzos F. Laparoscopic versus open appendectomy: which way to go? World J Gastroenterol. 2008;14:4909-14. [CrossRef] [PubMed]
Khalil J, Muqim R, Rafique M, Khan M. Laparoscopic versus open appendectomy: a comparison of primary outcome measures. Saudi J Gastroenterol. 2011; 17(4):236-40. [CrossRef] [PubMed]
Kurtz RJ, Heimann TM. Comparison of open and lapa-roscopic treatment of acute appendicitis. Am J Surg. 2001;182:211-4. [CrossRef] [PubMed]
Li X, Zhang J, Sang L, Zhang W, Chu Z, Li X, Liu Y: Laparoscopic versus conventional appendectomy - a meta-analysis of randomized controlled trials. BMC Gastroenterol 2010,10:129. [CrossRef] [PubMed]
Lin HF, Wu JM, Tseng LM, Chen KH, Huang SH, Lai IR. Laparoscopic versus open appendectomy for per-forated appendicitis. J Gastrointest Surg. 2006; 10: 906-10. [CrossRef] [PubMed]
Liu Z, Zhang P, Ma Y, et al. Laparoscopy or not: a metaanalysis of the surgical effects of laparoscopic versus open appendicectomy. Surg Laparosc Endosc Percutan Tech. 2010;20(6):362-70. [CrossRef] [PubMed]
Mascolino A, Scerrino G, Gullo R, Genova C, Melfa GI, Raspanti C et al. Large retroperitoneal abscess ex-tended to the inferior right limb secondary to a per-forated ileal Crohn’s disease: the importance of the multidisciplinary approach. G Chir. 2016;37(1):37-41. [CrossRef] [PubMed]
Mason RJ, Moazzez A, Moroney JR, Katkhouda N. Laparoscopic vs Open Appendectomy in Obese Pa-tients: Outcomes Using the American College of Sur-geons National Surgical Quality Improvement Program Database. J Am Coll Surg. 2012;215(1):88-9. [CrossRef] [PubMed]
McBurney C. The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg.1894;20:38-43. [CrossRef] [PubMed]
Merhoff AM, Merhoff GC, Franklin ME. Laparoscopic versus open appendectomy. Am J Surg. 2000;179: 375-8. [CrossRef] [PubMed]
Milewczyk M, Michalik M, Ciesielski M. A prospective, randomized, unicenter study comparing laparoscopic and open treatments of acute appendicitis. Surg Endosc. 2003;17:1023-8. [CrossRef] [PubMed]
Mohamed AA, Mahran KM. Laparoscopic appendec-tomy in complicated appendicitis: is it safe? J Minim Access Surg. 2013;9:55-8. [CrossRef] [PubMed]
Moore DE, Speroff T, Grogan E, Poulose B, Holzman MD. Cost perspectives of laparoscopic and open appendectomy. Surg Endosc. 2005;19:374-8. [CrossRef] [PubMed]
Nakhamiyayev V, Galldin L, Chiarello M, Lumba A, Gorecki PJ:Laparoscopic appendectomy is the preferred approach for appendicitis: a retrospective review of two practice patterns. Surg Endosc 2010, 24:859-64. [CrossRef] [PubMed]
Olmi S, Magnone S, Bertolini A, Croce E. Laparoscopic versus open appendectomy in acute appendicitis: a randomized prospective study. Surg Endosc. 2005; 19:1193-5. [CrossRef] [PubMed]
Paladino NC, Inviati A, Di Paola V, Busuito G,Amodio E, Bonventre S et al. Predictive factors of mortality in patients with acute mesenteric ischemia: A retro-spective study. Ann Ital Chir. 2014;85(3):265-70. [PubMed]
Pedersen AG, Petersen OB, Wara P, Ronning H, Qvist N, Laurberg S. Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg. 2001;88(2): 200-5. [CrossRef] [PubMed]
Sauerland S, Jaschinski T, Neugebauer EA. Laparo-scopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010(10):CD001546. [CrossRef] [PubMed]
Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010;10:CD001546. [CrossRef] [PubMed]
Schellekens DH, Hulsewe KW, van Acker BA, van Bijnen AA, de Jaegere TMH, Sastrowijoto SH et al. Evaluation of the diagnostic accuracy of plasma mar-kers for early diagnosis in patients suspected for acute appendicitis. Acad Emerg Med 2013;20:703-10. [CrossRef] [PubMed]
Semm K. Endoscopic appendectomy. Endoscopy. 1983;15:59-64. [CrossRef] [PubMed]
Shaikh AR, Sangrasi AK, Shaikh GA. Clinical Outcomes of laparoscopic versus open Appendectomy. JSLS 2009;13:574-80. [CrossRef] [PubMed]
Shaikh MR, Ali A, Saeed S, Ali N, Rauf H, Shaikh NA. Laparoscopic Versus Open Appendectomy, A Com-parative Study. J Liaquat Uni Med Health Sci. 2019; 18(02):90-3. [CrossRef]
Towfigh S, Chen F, Mason R, Katkhouda N, Chan L, Berne T. Laparoscopic appendectomy significantly reduces length of stay for perforated appendicitis. Surg Endosc. 2006;20:495-9. [CrossRef] [PubMed]
Vernon AH, Georgeson KE, Harmon CM: Pediatric laparoscopic appendectomy for acute appendicitis. Surg Endosc 2004,18:75-9. [CrossRef] [PubMed]